Healthcare Provider Details

I. General information

NPI: 1790425536
Provider Name (Legal Business Name): ANDREA NOEL WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANDI NOEL WILLIAMS

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CLIFTON RD NE
ATLANTA GA
30322-4200
US

IV. Provider business mailing address

2178 HOLLY HILL DR
DECATUR GA
30032-5715
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-7551
  • Fax: 404-712-8217
Mailing address:
  • Phone: 404-200-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License NumberRN228128
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: